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Saturday, September 01, 2007
Bill Steigerwald :: Townhall.com Columnist
Uh-oh, Canada
by Bill Steigerwald
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Will the Dems' health care Christmas Present to America be an improvement or detriment to our health care system?


If Canada's national health-care system is so dang wonderful, why are so many Canadians coming to America to pay for their own medical care?

Why is the hip replacement center of Canada in Ohio -- at the Cleveland Clinic, where 10 percent of its international patients are Canadians?

Why is the Brain and Spine Clinic in Buffalo serving about 10 border-crossing Canadians a week? Why did a Calgary woman recently have to drive several hundred miles to Great Falls, Mont., to give birth to her quadruplets?

It's simple. As the market-oriented Fraser Institute in Vancouver, B.C., can tell you, Canada's vaunted "free" government health-care system cannot or deliberately will not provide its 33 million citizens with the nonemergency health care they want and need when they need or want it.

Courtesy of the institute, here are some unflattering facts about Canada's sickly system:

Number of Canadians on waiting lists for referrals to specialists or for medical services -- 875,000.

Average wait from time of referral to treatment by a specialist -- 17.8 weeks. Shortest waiting time -- oncology, 4.9 weeks. Longest waiting times -- orthopedic surgery, 40.3 weeks. Average wait to get an MRI -- 10.3 weeks nationally but 28 weeks in Newfoundland.

Average wait time for a surgery considered "elective," like a hip replacement -- four or more months.

Hello, Cleveland.

The Canadian system is horribly short on consumer choice and competition. But it isn't all bad -- if you don't mind waiting to access it. As health policy analyst Nadeem Esmail of the Fraser Institute said last week, it does "a decent job of saving your life but treats you terribly in the process."

Esmail says no one knows exactly how many Canadians go to the United States each year for medical care. His best estimate for 2006 -- a conservative one -- is 39,282. Whatever the actual number is, however, it is growing.

Clinics in Detroit and Buffalo market speedy MRIs, CTs or ultrasounds to Canadians which, by law, cannot be purchased privately in some provinces, including Ontario.

Ontario residents have three options: wait months for their free public MRI, travel to a province like Quebec where it is legal to buy one privately or travel to the U.S.

It's no wonder private medical and surgical brokers like Timely Medical Alternatives of Vancouver have sprung into existence. Rick Baker said his three-year-old company refers about 100 Canadians a month to U.S. clinics and hospitals for such things as MRIs and knee replacements.

Timely Medical's services came in handy for Lindsay McCreith, a retired auto body shop owner who was told in 2006 he probably had a brain tumor. He needed an MRI fast. But the wait time for a "free" public one was 4 1/2 months and it was illegal to purchase a private MRI in Ontario.

McCreith contacted Timely Medical, which got him an MRI the next day in Buffalo that showed he had a Titleist-sized tumor. Four and half weeks later, McCreith had received the brain surgery that could have taken eight months to happen in Canada -- if he had still been alive. It cost him $28,000 -- for which Canada's government won't reimburse him.

Stories like McCreith's -- and the downsides of Canadian and American health care -- will be exposed Sept. 14 by ABC's John Stossel in his "20/20" special, tentatively titled "Sick in America." Rick Baker hopes Hillary Clinton and her friends will be watching.

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About The Author
Bill Steigerwald, born and raised in Pittsburgh, is a former L.A. Times copy editor and free-lancer who also worked as a docudrama researcher for CBS-TV in Hollywood before becoming a reporter for the Pittsburgh Post-Gazette and a columnist Pittsburgh Tribune-Review. Bill Steigerwald recently retired from daily newspaper journalism..
 
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Don't these Canadian fools
Realize that they're coming to the country with the worst health care system in the world.
Why would they want to do that when they only need to call Michael Moron, who'll be happy to fly them to Cuba to take advantage of the world's GREATEST Health Care system?

I mean REALLY, why settle for the worst when you can have the best. Right Michael??

Charlie S
Bingo.

It is a shame that the US is geographically in the way of superior health care for Canadians. Perhaps we can implement a 21st century 'underground railroad' for them to shuttle off to the people's republic of Cuba.

While I have sympathy for Canadians with health issues, I have none for putting themselves in that situation. They chose socialism. Perhaps its high cost in dollars and lives will prompt them to choose more intelligently in the future.


We are lucky
to have the fast moving folks in places like Canada, Cuba and the old USSR to lead the way in demonstrating the benefits of socialism. Without them, we would be in the front line of discovering the socialist utopia ourselves.

killing the golden goose
I agree that we have the best health care system in the world-- but we are paying a VERY steep price for it, and the providers risk killing the golden goose. We pay TWICE per capita what ANY other country pays, yet our life expectancy is no longer. Ergo, prima facie, we spend at least twice too much.

I teach business at the college level and was a career banker before that-- I believe in the market system. However, while liars do figure, figures do not lie-- our costs are WAY out of control. We spend 90% of our health care $ on the last 90 days of life, meaning we are subsidizing failure. M. Deities surely deserve to be well compensated, but they average > $200k, or FIVE times the average household. The pharamceutical companies are exceeded in influence in Washington only by #1 AARP and #2 the collective Jewish lobbies; the first helped win the drug companies their big government boondoggle Rx Care for Seniors.

We simply cannot tolerate drugs which cost $5-10 per PILL due to drug selling exclusives, and the physicians effectively have an oligopoly on a vital service. Consider how often you need to see a doctor versus, e.g., a lawyer or CPA, yet the number of physicians is controlled. We have a "cost push" system-- and the costs are pushing WAY TOO HARD.

Also
Part of these waits is due to "unintended consequences" of the overregulation and bureaucracy of Canada's system, coupled with NAFTA.

The overregulated doctors see greener pastures (I'm not sure they necessarily know about dealing with HMO's/PPO's, which may seem on "armchair analysis" as "six of one, half-dozen of other" exchange) south, and can go there on NAFTA--and many do so.

And I have more than once mentioned why you see a lot of Canuck nurses on this side of the border.

When you live here
you find out why socialism not only does not work, but why it cannot work. And if you watched the video of the looting of that Wal-Mart in New Orleans, where even the cops were wheeling shopping carts out the door, you will know why.

If people have the mistaken idea that something is *free*, they will loot it right down to the ground. You will have the devils own time explaining to any of these looters that their definition of *free* is really *I never have to see the bill.*

A few years ago I had a sudden spike in my blood pressure, which was caught in a screening provided by my office. The nurses urged me to see a doctor that very day. The problem was that in six years of living in Canada I had been unable to FIND a doctor that would take me on. I spent the next four hours in a walk-in clinic, where the extremely foreign doctor who finally saw me told me he could do nothing but *watch* my blood pressure -- no prescription, no tests, no nothing! Fortunately someone at my office got me in to see her doctor, who promptly began to treat my problem.

And of course there is the Run to the States Story that everyone who lives up here can tell you. I discovered that I had suddenly lost some of the vision in my left eye, and my office sent me to the emergency room where, after five or six hours, I received really excellent tests and diagnosis. And then I was told that the treatment I needed was not available in Canada at all! The only thing they could offer me was a 1960s treatment that would have required me to lie face down and totally immobile for at least six months in hopes the problem would resolve. Fortunately I had a friend in Tennessee who was an opthalmological nurse, and she and the clinic she works for offered me instant treatment, which is day surgery in the USA. Once I returned to Canada, it took 8 months for me to get a referral to an opthalmologist for follow up.

And
do not try to tell me this is *free*. I pay an extra extorted *health premium* of $900 per year over and above the extortionate taxes already extracted from me, by the Province of Ontario, levied by the Liberal Premier who promised before election he would not raise taxes. This is the biggest tax grab in Ontario History; and it does not go for health care. It is shoveled into the General Coffers, where it is shoveled out to buy votes.

Simple Solution
Obviously the problem with the Canadian system is the fact that there exists a way for Canadians to access healthcare outside of the Canadian system. All they have to do is make it so people there can't leave. The Soviets did that for years, works great.

Good Stuff, Lodestar
I don't really doubt your figure of 90% on the last 90 days, no more than with the grain of salt i apply to any blog statement. If true, and it probably is, it is illuminating. Huge costs could thus be saved by relatively small efficiencies in the last 90days of life. Several colloraries occur to me. If only 10% of our costs are spent prior to the last 90 days, we are achieving comparable life spans to say Sweden, with 10% of 200%, which is 20%. This certainly indicates the relative efficiency of non-govt vs govt controlled "free" health care. And this is in a society not benefitting from the homogenous makeup of most competing systems. It also illustrates the crazy costs of bringing a hospital and doctor on to the scene. You seem to be in the know. Any suggestions?

"A Decent Job of Keeping You Alive?"
I agree with AudiR10, Canadian emergency care is as good as their elective care. My wife & I differed politically for many years. She is now reliably Conservative, for two reasons. The first is an issue that always bothered her – guns. She’s a smart lady & was always bothered by the dichotomy of liberals who claim to want to empower women – but of course if a woman is attacked in the liberal world she must dial 911 and wait for someone to rescue the poor little girl.

She always thought our health care system was fatally flawed because the market decided. I always looked toward Winston Churchill, believing that our system is the worst in the world – except for all the others.

How was she converted? Courtesy of an a**//// snowplow driver in Sturgeon Falls, Ontario. Another driver ticked him off, so he drove like a jerk, and caused an accident we were involved in. My wife was taken to hospital [sic] in Sturgeon Falls. She emerged voting as conservatively as she lives her life.

As fun as it might be to load all Americans who think our health care system is “unfair” into station wagons & then run them into trucks in Canada, I don’t think this is a practical way to create a Conservative majority. But I encourage all who have sampled the socialist paradise to the north, especially Canadian expats, to tell all your friends and acquaintances in the US how wonderful Socialized medicine is.

Canadians with Lyme Disease are screwed
I have chronic Lyme, and anyone who has it or knows anyone with it realizes we are better off dead (and want to be dead) if left under or untreated. I have met quite a few Canadians in my Lyme doctor's office because they cannot get the long term, open ended treatment for Lyme in Canada under the "free" health care plan. Only wealthier Canadians or those who somehow curry support can get well. I can't help but think that is just what Hillary and her ilk have in mind: national health care would not affect them. Let them eat cake!

As it stands, it is difficult enough to deal with some of the lunk-heads here in the states around disseminated Lyme. National health care would nail our coffins shut by removing the few choices in doctors that we have to treat Lyme.

Costs can be controlled by
tort reform and managing immigration. We provide health care to anyone who needs its or contrives to need it- this cannot continue.

In addition, pharmaceuticals must go through more extensive and expensive research trials in America due to the litigation risk. This all adds up.

Another example is fat people who sue because they had a heart attack, have diabetes, ulcerated sores that won't heal, etc... that they are fat and must lose weight to improve their health. As it stands now, fat people can sue the doctor who tells them they are fat! Addicts who take antidepressants and continue to use drugs then have adverse reactions have sued and won- I've seen this happen. The issue is NOT our health care system, it is our application and distribution of it.

Great satire, Mr.Stone :) !
Unfortunately, the same ideology that gave us New Orleans and our other urban armpits wants to take over your health care! I do think the producers are outnumbered by takers at this time in history, so it may happen. Yikes!

Health Care
A large proportion of the total cost of care is in the last months of life, but I don't think it is 90%. But in the US, who pays this cost - the overwhelmingly the government through Medicare, which pays more than 50% of all medical costs. If a government system is so great, why isn't it already moving things in the 'right' direction?

I bristle when I hear health care quality judged by life expectancy. So many of our ills are the result of life choices which we then look to doctors to fix. Health is our responsibility, although we can look to others for care.

Put Canada On Display
The Republicans need to campaign heavily on this issue. Older people vote more than any other age group and for older people, having access to immediate tests and surgery is extremely important. The Canadians who come across the border for medical services are probably scared to death the American system might change. Maybe the Republicans should put them in their TV ads.

It's worth noting, too.
That Canada has one tenth of the population of the U.S. - we can expect Yankee socialized medicine to be even less efficient.

Lodestar and all
In answer to your comment about paying too steep prices in the U.S., maybe part of the reason is we expect the insurance company to pay the whole bill, not just part, but all, and not based on the premium we pay but based on the cost of the treatment and our demand of all bills be paid for. And, in the doctor's and hospital's cases, they are forced, because of fear of lawsuits, to perform every test known to man in order to eliminate any possibility of the slightest abnormality someplace or the threat of lawsuits. Why are prices so high? We demand every tiny hurt and discomfort be diagnosed by use of million dollar diagnostic machinery and tests. Then, adding another layer of cost, is the everlasting and unnecessary protective paperwork. Do you realize that every time you go in a doctor's office or hospital, you must be presented with the government's idea of protective authorizations and notices of information protection and safeguards, signed of course. Every time your insurance company sends you any type of information or report, they must send you their "Notice of Information Practices". Are these necessary? No, probably not in the vast majority of cases, but do they add cost (printing and distribution), yes! If you had to work in a doctor's office or a hospital, and saw the autocratic and unnecessary duplicative paperwork that must accompany every occasion of treatment, you would scream. And, this is all coming to you courtesy of Big Brother, who in his (soon to be her) opinion is necessary "for your protection. But, cheer up, we are still in the land of the best and most widely available medical care in the world, despite Michael Moore's lies.

Did anybody catch...
...the part where it is ILLEGAL in Ontario to get a private MRI? It is ILLEGAL to get medical diagnosis. Amazing.

America has socialized medicine already
It's called the "Military Healthcare System." It is the best, probably most efficient system in lifesaving. But as far as long-term care...its a nightmare.

What happened at Walter Reed is an extreme, but there are plenty of Marines, Soldiers, Sailors and Airmen who could make you cry if they told you about having to deal with long-term healthcare issues.

"Here's a prescription for Motrin...come back in 2 weeks if there's still a problem...NEXT!"

One of Lodestar's points
is inescapable: Health care in the USA DOES cost a lot of money. It is, quite simply, expensive to be sick in America.

But it is not often extremely dangerous, as it easily can be in other countries and as AudiR10's experience with hypertension illustrates. And I believe uwcharlie is absolutely correct in his reasoning about why health care is so expensive -- lots of unnecessarily utilization on the parts of consumers and lots of unnecessary over-regulation from both state and fed governments.

I do not believe that requiring insurance for everyone will do anything other than shift costs and it will help make insurance companies richer. Physician practices are MASTERS are how to game the insurance industry (as anyone who has insurance ought to have figured out). MANY of the items cited by uwcharlie above are ways that all of us could influence costs and make a start at driving them down.

some follow-up thoughts...
Some of our costs are surely due to a large diverse population and terrible lifestyles-- fast food, etc. Black Americans (13%), e.g., have atrocious morbidity stats. Trial lawyers claim that litigation adds only 1% to health care costs, but this seems counter-intuitive; in my house we have paid for 2 MRI's in the past 2 years that were surely defensive medicine overkill.

The government IS indeed already too involved in the process: did you know that those "free" scooter chairs actually cost taxpayers $6k per when they should cost perhaps 1/3 of that? The red tape is indeed expensive-- hey, we have bureaucrats to support handsomely! I grew up living with a physician-- have heard about all of the hassle and costs. Still, most M. Deities live VERY well. At the end of the day, 2 TIMES the cost for the same life expectancy simply speaks for itself. The drug companies are shamefully voracious, and effectively oligopoly providers. Congress is WAY too controlled by these powerful lobbies: drug companies, the AMA, and trial lawyers.

Why is it so expensive?
Lawyers? Corporations? Regulations?

Health Care
If we truly had a free market system in health care, would the cost go down? I think they would. But the politicians would have to leave things alone instead of their eternal tinkering.

lodestar . . .
"We pay TWICE per capita what ANY other country pays, yet our life expectancy is no longer. Ergo, prima facie, we spend at least twice too much."

I would agree except we don't seek medical care just to extend our lives. The orthopedic surgery that saved my foot didn't extend my life but it was worth the money. I do believe that some form of health care rationing is essential. There is no cure for old age, but my 91 year old mother-in-law's medical and nursing home costs are enormous and she doesn't even know it. Neither does she recognize either of her daughters. Yet heroic measures are employed to keep her living on.

Insurance Inefficiencies
Ask yourself how much auto insurance would cost if the government mandated the insurance companies paying for your oilchanges and new tires. Auto insurance would go through the roof as would the cost of tires and oil changes. That is what we have done to healthcare. Medical and insurance costs are out of control precisely because of government interference and we are told the way to fix it is through more intrference.

We are stupid and we deserve what we are getting.

Realist
Certainly rationing is what the system needs. Tha question is what form does the rationing take. Does the consumer decide based on needs and costs or does the government decide based on who knows what kind of baloney?

Please tell your wife you want to give the government the power to end her mothers life because it costs too much and she's a vegetable anyway. Good luck after that.

Everything is rationed based on the needs, desires and ability and willingness to pay. The locus of decision making is the controlling factor and the further from the consumer that power to decide is located the more inefficient the process becomes.

We are paying too much now because decision making is being taken from the consumer. In nearly every area of our economy where the consumer can apply choice the market provides lower prices and better service. Healthcare should be no different.

THE PUBLIC APPEAL OF UHC

.....Because it is "FREE" ...or so they think ...

.....Bill ...your article makes perfect sense to logical people who take the time to study the facts ...but unfortunately that applies to only a small portion of the public ...all most people respond to is the word FREE ...whether a single payer system run by the Government or a paid insurance program supplied by the employer ...

.....As long as the patient does not have to pay the bill directly they believe it is free because someone else is picking up the tab ...what they never see is that ...that someone else is them ...

.....I recently had a minor surgical procedure ...when the Doctor ...Medical Facility and the Anesthelogist all realized that I did not have medical insurance ...they all agreed to cut their fee in half if I would pay them up front ...so if I had insurance they would have charged double ...who pays for that? ...who picks up the other half of my medical bill if I am insured? ...

.....When I was five I had the mumps ...the Doctor walked up three flights of stairs to treat me and charged my aunt his usual $10 house call fee ...but we have advanced from those simple days ...today we have HMOs and Heath Insurance .....COLOSSUS

Regarding the evil drug companies
I was a (small) part of a cadre of attorneys gathered in a large room for weeks, sorting through a large drug company's documents as a (small) part of an effort to satisfy the Government's demand for discovery--to cover e-mails, letters, forms, etc. generated within the company. Apparently the Government thought this company had somehow run afoul of some rule or law. Think the company incurred any costs in the course of this investigation?

Drug companies aren't greedy, faceless entities, intent on stealing from the people (though they are, at times, very inefficient). And you have NO idea the hidden costs they incur--in addition to the obvious & well-publicized costs of bringing a drug to market, and the litigation costs that often follow an effective drug (think Viox, e.g.)--which can cause drug prices to be high.

Also, many people do not know that most drug companies have programs to provide free drugs to the needy, through their physicians, upon minimal proof of inability to pay. Small wonder the drug companies were in favor of Government paying for the drugs of Medicare recipients!

Of course, Canada controls drug prices, so if a drug company is willing to market their drugs in Canada, they WILL be cheaper there.

Once Hillary is in charge, determines exactly how much profit is acceptable, and sets drug prices and physician prices accordingly, it will be only a matter of time before we are able to match Canada in wait times and quality of care. And there will be little incentive for drug research. And NO reason for Canadians to seek care here. There's some chance it will not happen before I die. Some chance.

baseballdoc
I AM insured, and after each medical visit, test or procedure my insurance company sends me an "EOB" (Explanation of Benefits). The "agreed" provider savings are quite often greater than 50%, sometimes closer to 90%.

When I saw what the laboratory received after my blood test last year, I wondered how they could even afford to DO the test.




Add a surcharge for Canadian patient
Remind me again why the Canadians think they're better than the USA. We should add a Canadian patient surcharge. Canadians still like to defend their "free" system, though.

lodestar writes: 9/ 01, 2007 6:21 AM
.. we have the best …..but we are paying a VERY steep price... and the providers risk killing the golden goose. We pay TWICE per capita what ANY other country pays, yet our life expectancy is no longer.

DESKJOCKEY

Giver-ment, not providers, are the problem. We pay twice per capita on average. Luxemburg is close to us, Norway and Switzerland high. Add Canadian’s US health care they’d have a higher cost.

It is estimated that 20% of cost is compliance paper shuffling. Litigation costs are exorbitant. Giver-ment purchases 50% of our services. End that phony demand, prices will collapse. End 20 million illegals pouring in for free baby deliveries and bringing diseases we never heard of. End free hospital care. Also, our high risk culture of murder, bad health habits, risky sports and behavior etc add to death rates.

lodestar

I … was a career banker …I believe in the market system….. spend 90% of our health care $ on the last 90 days of life, meaning we are subsidizing failure. M. Deities surely deserve to be well compensated, but they average $200k, or FIVE times the average household. The pharamceutical companies … first helped win the drug companies their big government boondoggle Rx Care for Seniors.

DESKJOCKEY

Bankers hate the market system, witness them demanding Bush bail out their mortgage debacle, no different than they demanded we bail out their South AmeriKan loan debacle in the early 80’s and again in the early 90’s with Mexico.

When a third party pays for the last 90 days, why not milk it for all its worth? To reduce M. Deities compensation, remove artificial demand and tax payer subsidized third party payers (corporate plans).

Rx Care for Seniors was a pay off by Bush for Sidney Taurel, ex Chairman of Eli Lilly who got the drug folks to raise $3M for Bush to start his campaign. Daddy Bush sits on the board. Why shouldn’t companies invest a few million to get billions out of the taxpayers? Who needs politicians otherwise?

Welcome to de-mob-ocracy
It is true that the takers outnumber the producers, but that fact would be immaterial if the Supremes would enforce our Constitution (Article4, Section4). Our founders rejected democracy in favor of a republic to prevent raids on the producers in the name of the common good. They mandated that the best way to promote the common good was through a limited government. However, both the left and right wings of Control Freaks Unanimous talk constantly about our "wonderful" democracy, and all it takes is 50.01% to take everything you have, including your ability to buy health care. http://www.poorgrandchildren.com

Is This A Free Country?
If this is a free country then where's all my free stuff? Or, to put it in the words of one of our local TV newscasters during the HillaryCare debate in the mid-90's, "Free Healthcare, how much will it cost?"
We've now had a century of governments nationalizing industries in the name of fairness and the results are always the same; scarcity, much higher costs, preferred access for the well-connected, and an end to innovation. Anyone who can look at the results of the many national-government health systems around the world and still be in favor of nationalization is a fool. Unfortunately if you attach the word 'free' to anything these days the hogs will come arunnin. This debate is just the Democrats yelling, "Sooooey!" and banging on the swill bucket. Reasoned arguments will have no effect, after all, its a Free Country, isnt it?

Typical
This free health care mantra is typical of the free lunch, free food stamps, free housing, free public schools dog and pony show that has ruined this nation. No one has any responsibility for anything when it is free.

Why can't Johnny read? Well you shouldn't complain, after all the school is free.

Why do we have all of this crime in the public housing projects? You shouldn't complain, after all it's free.

Why can't we get treated for health problems? Who are you to complain? After all it's free.

Ahhh yes. Free. What a wonderful concept.

To really fix US health care (1)
To really fix the US health-care funding mess, three things are needed -- and none of them will happen.

(1) Cut the lawyers out of the loop. Completely. Maybe you could get away with redefining medical malpractice as gross negligence instead of ordinary negligence; but I would prefer the law to say that since all doctors are licensed by the gov't, and all drugs and medical devices are licensed by the gov't, then the gov't should accept the liability that accrues to those people, chemicals, or devices; and since, because of sovereign immunity, the gov't can't be sued, medical malpractice lawsuits would be ended. Please don't tell me that the docs and nurses would then give us shabby treatment; I am old enough to remember when all these malpractice suits didn't happen, and the docs did their best back then, as they generally do now.

(2) Cut the doctors out of the loop. There are many drugs, medical devices, and treatments that do not have common, serious side effects; yet you have to go to the Dr. to get the prescription, and the Dr. gets his (large) cut. Allow people to do their own health care as much as possible. Don't worry about the docs; there will still be many drugs that will have to be by prescription only, and many, many treatments the docs will have to give. They'll still have plenty of business, thank you. To be continued...

TNSTAFL
The wisdom of the ages has been condensed to one sentence: There's no such thing as a free lunch. It certainly applies to health care, which is not health care as much as it is "sickness care".

To really fix Us health care (2)
(3) Make medical insurance a taxable benefit. As soon as that happens, everyone will get away from the system we have now (third-party payment for everything) and opt for catastrophic coverage only, so they can get paid more real money. Then they will shop, shop, shop for their medical care, and market incentives will drive prices down. Remember, although medical costs have gone through the roof in recent years, plastic surgery prices have dropped, because plastic surgery is not covered by insurance and so market incentives come into play.

If all three of these policies were enacted, health-care costs would drop like a rock. But they will never happen. Elimination of malpractice torts will never happen because the trial lawyers (along with the NEA) run the country. Reducing the need for doctors to prescribe all kinds of health care and allowing people to run their own health care will never happen because the Drs. and the rest of the health care people would lose power and money, and while they are not as powerful as the trial lawyers, they hold enough clout in Washington to block it. Making health benefits taxable and thus forcing health care back into the market will not happen because the libertarians will scream that taxes are going up, and the liberals will scream that some people will take the money that used to go for their health care to the casino, since we all know that people cannot run their own lives and must have Hillary to take care of us.

Polly
That was an excellent answer to lodestar, and, were s/he not a drive-by poster uninterested in debating, I would include hdhouse as your other target.

I would expand on your post, however, Polly, by pointing out just one example of how socialists cook the books when they argue for their power grabs. In the case of prescription drug prices, the price controls in Canada artificially deflate the per-capita healthcar expenditure there (as well as in all socialized medicine countries). Since these below-market prices limit the capital for the pharmaceutical companies (which is needed for research and development or newer, life-saving medications), the pharmaceutical companies are forced to raise the prices in the U.S. This, of course, artificially inflates the per-capita healthcare expenditure in the U.S.

Therefore, socialized medicine in the U.S. would be the end of medical research.


TNSTAFL
Wisdom of the ages: There's no such thing as a free lunch. That certainly applies to our system of "sickness care". (It's not health care)

Canada's public health care
Where's the numbers of Americans who are flying to Indian, Germany and other places for their operations. They can pay for their flight and still save thousands of dollars left over compared to what they would pay here.

I have several Canadian friends and they say the wait time is not that bad. A wait for care may be irritating but they are not letting their poor children go without medical care. We have in our state poor children who loose their hearing due to ear infections as their parents can't afford the doctors fee. Or kids loose their teeth to decay as they can't afford to see a dentist.

Our system needs changes. My daughter is a Physician's Assistant. She told me she would have only $10,000.00 left per year to live on if she had to pay her liability insurance herself. The clinic where she works pays for it for her. Our dollars are not buying medical care it is going to pay insurance companies and lawyers.

chicares
There are problems with our health system in the US. There is no question about that. The question is what are best ways to deal with that. One of the fixes is tort reform so someone like your daughter does not have to pay huge amounts for insurance.

Government Health Care?
Why would any one think a government( especially ours) can do any thing efficiently, cost effectively, & with out Bureaucratic nonsense certainly escapees me.

EQUAL HEALTH CARE FOR ALL
A complete overhaul of our entire health care system is necessary.

EQUAL HEALTH CARE FOR ALL (ISBN 13: 978-0-9796994-0-5)

http://www.equalhealthcareforall.com

Doctor K

doctork
We don't want EQUAL healthcare. We, each and all of us, want the BEST healthcare.

I'm sure Hillary will make sure that all in government are required to use only the "Universal Health Care" system, herself included, as we wouldn't want anyone to get better health care because they think they're better.

Perhaps she will ask for a law requiring all doctors to be The Best?

doctork
Oh my goodness, I just clicked on your link.

"That negotiated cost (price) control does not imply the loss of protected, reasonable profit margins for health care businesses or health care rationing by the single payer, but it does mean the removal of unbridled, egregious profits, also known as, greed."

Are you lobbying for a position on Hillary's "Acceptable Profit Committee"?


HMO's
Are the root of the problem. Get rid of them. They are a not needed middle man driving up costs with a bureaucrat making decisions that you and your doctor should be making together. They also proliferate abuse.

In spite of my joke
At the beginning of this thread, it's plain to see that most of us know why health care costs are way too high.
The government, through ridiculous over regulation of every part of the medical system, has its greedy paws into yet another aspect of our lives where has no business being.
Yet the vast majority of American people just put up with it so that they don't have to bother getting involved in running/controlling their own lives.
It's very easy to see how the costs of everything would plummet if we could only get the government out of it.
End government regulation(FDA) of research on medicines and drugs and the costs would plummet.
End government regulation of how doctors must perform certain procedures and costs would plummet.
End the all too ENDLESS, and getting worse, amount of unneeded and useless paperwork and record keeping, and medical costs would plummet.

But most of all, as several have stated, GET THE DAMNED AMBULANCE CHASERS OUT OF THE PICTURE

Polly
Thank you for reading my comment and replying. When I say "EQUAL HEALTH CARE FOR ALL" I specifically mean clear and equal access to vital, comprehensive health care for everyone living in the USA. No one in any health care system can guarantee outcome; but quality assurance protocols can be put in place to determine the presence of high standard of work from all those involved in the effort to treat sick people.
The health care proposals of Senators Clinton and Obama are in my view a joke. Nothing will change to benefit individual people living in America because they pander to the insurance industry. The economic discrimination rampant in our current system will not change with their proposals. However, the Republican proposals are no better. To believe that market mechanisms will solve our health care problems, when those same market mechanisms are responsible for the economic discrimination, I think is not tenable.

Why is it that all the major candidates for the presidency, in both parties, offer no more than maintaining the status quo?

Because the Canadians run their single payer system incorrectly does not mean that a single payer system, developed and run by Americans, is not the answer for our health care problems.

I try to develop this system in my book and on my website. Please contact me. I welcome further dialogue. I do not have all the answers.

R. Garth Kirkwood M.D.
doctork@equalhealthcareforall.com
http://www.equalhealthcareforall.com

As I was saying
But most of all, as several have stated, GET THE DAMNED AMBULANCE CHASERS OUT OF THE PICTURE and we'd see the biggest drop of all in the costs of medical care since it's the fear of malpractice suits that have don the most to drive up medical costs thru repetitive, usually unnecessary testing done just to insure that some slimeball who's looking for a way to get rich quick, backed by a greedy ambulance chaser, doesn't get the chance to destroy the doctor thru ONE ridiculously high dollar FRIVOLOUS lawsuit.

Johnny "Breck Girl" Edwards(channeling a dead baby, anyone remember that) is all the proof we need that this happens all too often.

Lolo2
As I recall, HMOs were a creation of Congress, an effort to improve access to medical care.

With the feds listening in to all your phone conversations now, don't be denigrating the efforts of Congress. The important thing is, they have good intentions.

doctork
I'm sorry, Doctor, but you've hit too many of my hot buttons.

The Democrat motto always seems to be "Oh sure, it has never worked anywhere else, but we can make it work here." (That in response to your "Just because the Canadians can't do it right..." comment.) Unfortunately, I believe human nature is fairly universal. If something doesn't seem to work anywhere it's tried, I see no reason to think it will work if it's tried one more time. And I see much to be ruined in the process of finding out.

Your apparent obsession with "The economic discrimination rampant in our current system" kind of makes me cringe. You seem to want to destroy any incentive for one to improve oneself. I think Bill Gates DESERVES to be able to purchase the best medical care. He may WISH to help strangers pay for their own medical care, but that should be his choice, not Hillary's.

All too soon I will enter the "single payer system" myself, as I don't believe we are allowed to opt out of Medicare (and besides, I've been paying for healthcare for the elderly for many years--since its inception, in fact; y'all can pay for mine for a while now). Of course, since Medicare is broken I'm sure the Democrats will soon ask for "means testing," as they've often hinted at, which will make Medicare a plain ol' welfare program. How that will mesh with Universal Health Care, I can't even imagine.

Let's not dismiss the idea
Let's not dismiss the idea out of hand; instead, let's try an experiment.

Socialize legal services: free lawyers for everyone!

If that works then I'll consider UHC...

Grumpy
Woo, talk about "tort reform"!

I LIKE it.

No, I LOVE it.

Polly
Your hilarious! Yes they were the creation of Congress led by little Teddy Kennedy. So what does that tell you? Has he ever implemented or done anything sucessfully?

HMO's have not improved access they have restricted it by driving up the costs.

Once again if the govt. is involved they screw it up.

Grumpy
I second your motion!!!!

Grumpy, p.s.
Of course, legal services ARE currently available for the poor. But with "the economic discrimination rampant in our current system," I don't think anyone would call their representation "equal."

Once the whole system is socialized, however, I think we can safely predict "equal" representation, yes? Maybe with a few tweeks to keep out the hacks, of course.

doctork
I have read your website. You are operating under the premise that the Constitution should guarantee healthcare for all. It does not. Socialized medicine takes away the incentive to be healthy. Actually the current system is doing that as well, then has the utter gall to persecute those that aren't healthy. It's only going to get worse. Look at all the corporations popping up telling people what they can eat, drink, smoke or do off the clock as well on the clock. They do it not because they care about them. They do it in the name of cost control. Just imagine what's going to happen with socialized medicine. You need not look very far. Look at England. How long before the govt. shows up to monitor every morsel someone puts into their mouth. Then of course taxes rise again to pay for the monitors. Let the vicious cycle begin.

Lolo2
Dang, Lolo, you're forgetting Teddy's good intentions.

Also you're forgetting Chappaquiddick.

Polly
LMAO!!!!

Free Lawyers for Everyone
Wow. That would almost force universal conscription - 2 years of service to the country - 1 in training to be a lawyer, one in providing the service, since, obedient to market directives, all of a sudden there would be no applicants to law school.

I don't know if anyone here reads Douglas Adams, but that would be our Shoe Event Horizon.

Grumpy, Lolo & Polly
I MUST AGREE, FREE legal services would indeed be the best way to get ambulance chasing lawyers under control.

But we all must never forget the words of wisdom from the great El Rushbo where Teddy the swimmer and the rest of the Democrats are concerned,
"It's NOT the results of their efforts that count, it's the GOOD INTENTIONS(yeah, right)behind their efforts"

Markets are the problem and the cure - 1
Instead of protecting people from their own choices by robbing from the rich to provide equally degraded health care to everyone, the best thing that could happen to Americans would be removal of 90% of the infrastructure supporting healthcare maintenance for conditions such as obesity, high blood pressure, etc.

But, in that respect, we are the victems of our market economy. The engine that provide us with more collective wealth than the world has ever known is the same miracle that allows us to eat what we want and fail to work it off with relative impugnity. Tall, fat, unexercized people die sooner. We're getting taller, fatter, and more unexercized, and employing the most comprehensive, powerful, and expensive healthcare system in the world to support our proclivities.

If the problem is in the markets, the solution is there as well. Socialized medicine, well underway in America in any case, will only make everyone die a little sooner and live a little more miserably, while having to fill out more forms and waste more time as well, damaging the ecomomy further and contributing futher to the degradation of the system that relies on that economy to fund it.

Markets are the problem and the cure - 2
Perhaps this is the socialists answer to global jihadism: Destroy, among others, major oil-using industries, forcing us back to bicycles, to live healthier lives while destroying the economies of oil-rich nations exporting terrorism. Well, destroying everyone's economies, but what the heck - a little collateral damage.

The conservatives answer in the past has been a charismatic leader who can convince people that their considerable talents, energies, and good intentions can be redirected; that their individual actions, outside of government can make a change. Reagan was such a leader. JFK was such a leader - democrat or no, if you look back you'll find many of his notions to be conservative today. Even Bush is such a leader, but not charismatic enough by far. I'm thinking that at some point someone will come along to make us believe that we are our own responsibilities, that we will learn to believe it, and that markets will erupt to support the notion.

Rich
I read Douglas Adams and you summed it up nicely.

A Question
Why is it every socialized medicine column I am forced to look at a picture of Michael Moore?

Okay another question.

Wonder if MM has figured out exactly how persecuted he is going to be under socialized medicine due to his rather rotund size?

Tough choices
A few very politically incorrect things will help drive down costs.

1) Do NOT require emergency rooms to treat everyone for everything when it comes to the uninsured and underinsured. For real life-and-death situations where someone will actually croak if they don't get treatment, okay -- treat. But every day thousands of people with no health care coverage visit their local ERs for scraped knees, hives and sore throats.

SAY NO. Compel these people to go to urgent care or walk-in centers, or to retail clinics if they are around. Compel these people to PAY SOMETHING for health care, like I do and like you do. Or -- let them take their scraped knees and sore throats HOME with them and treat them themselves. Period. Health care IS NOT a right and there is no gurantee of health care service for every little pimple, period.

2. Divert funds used to pay for "free" ER care for those lacking insurance into "minute clinics" and "retail clinics" in retail settings like Target, CVS and WalMart. These are staffed by APRNs for routine care and they charge extremely reasonable prices like $30 and $48 and $56. These make HUGE sense. I only wish I had one near me -- and I DO have health benefits.

Lolo2
Sorry, Lolo, but thru his hard work and farce, Michael has BECOME the face of socialized medicine.

Would you prefer a picture of Hillary? Or Teddy? I think not.

Arby
Very politically incorrect--and it ain't gonna happen. It's about as likely as Congress voting in term limits.

Socialized anything...
..has NEVER been shown to work regardless of who tried to make it work...

While the idea that everyone MUST have access to Medical care is admirable, it is a bit far fetched, almost as bad as saying that everyone must have Medical Insurance.

The main problem is very few of us have to pay for our care..Stossel's column has the figure of 6 out of 7 dollars spent are spent by someone other than patient. I spent (or tried to spend) as much of my parents' money as I could when was a teenager, but I'm a lot more careful with my own. I think the idea of Health Savings accounts would help as would making insurance do what it was designed to do..catastrophic coverage. You pay your Dr's bills for routine stuff your insurance pays for the exceptional problems..

anytime I hear
Something is going to be free, it goes like this:

Other: "Hey I hear people can get free healthcare in Canada!"

Me: "Really? Where did they find doctors and nurses to work for free? And where did they find all the free equipment to provide the free care?"

Other: Blank stare.

DavidM
Well said.

2 Guns
Americans have always been a can-do bunch. Surely Socialism will work here?!! Or maybe not. It's very easy to become spoiled by lots of "free" stuff--and not so easy to work really hard so that other people can take your stuff. (See, e.g., New Harmony, Indiana; Robert Owen--it actually HAS been tried here.)

Health Savings Accounts could be the answer, with insurance for catastrophic events, but everyone's so used to having insurance cover EVERYTHING it might be too hard to change things. Even the doctors might be stymied for a while. "What, charge a fee I actually expect to GET? In FULL?!!"

Big Daddy
I agree with your comments about military health care, but those problems have been going on for many years.

A specific example for me was that in 1970 while stationed in Thailand, my foot was broken and it wasn't treated until 1976 -- and then it had to be rebroken.

For enlisted personnel, the lower ranks tended to be looked on as shirkers if they went on sick call. When I as a senior NCO thanked a Navy doctor at Yokosuka NAS hospital for the excellent care he had provided for me, his statement was, "When a senior NCO or officer comes to see me, I take their complaints seriously because senior NCOs and officers know how to goof off without going to the hospital." And my experience supported that general idea and I was taken more seriously as a senior NCO than as an airman. My experience in the AF also was that the best medical care I got was when I was on flying status.

I was stationed at Lackland AFB from 1975 - 1978 and if a medical specialist was needed that was the best place to be, but for routine health care it wasn't really any better than any other base.

Clyde9

How to make health care affordable
Insurance companies should be allowed to provide a policy that provides health care along the lines of Canada.

Simply identify all the weaknesses of the Canadian system (long wait times, average medical care, certain procedures are not available, no recourse to the legal profession if there is a malpractice issue, no extensive testing - or none at all, and limits on the amount of care one receives) and say that is the maximum one gets with a basic policy.

Sounds like a policy that you could get for $900/yr not unlike AudiR10's policy in Canada.

The advantage to such a system is that insurance companies could offer this "no frills" policy to everyone who currently thinks that we need nationalized health care. This gets people the marginal care they want without sacrificing the quality of care the rest of us are willing to pay for. In fact, it can be made mandatory that you have to pay the $900 - take it out of the paycheck of everyone who does not have their own coverage.

With this system hospitals would not have to provide free ER care for sniffles.

Maybe AudiR10, you could elaborate on what a no-frills policy would look like based on the type of coverage you get in Canada.

Where`are all`these sick Canadians
I work for a hospital in the billing office and I have yet to see any hospital face sheets with addresses from Montreal or Quebec! In the good old USA we're stuck with the Titanic after the iceberg approach to health care--it's everyman for himself! Maybe all these sick Canadians aren't so desperate to come here after all!

no bs artist
Geez, no, where you workin', Miami?

And you mis-remember the Titanic. It was "Women and children first."

Signed,
A Woman

Polly
The thinking reflected in your posts impresses me! Not that you or anyone else lives to impress me, but thank you for some nice reading!

Wait times for MRIs in the US...
Are often 'forever', if your health insurance company refuses to cover it, or if you are the one in 12 Americans without health insurance.

And since many of those without insurance have none because they are 'uninsurable' and are unable to buy their own insurance at any cost, they don't exactly have a lot of 'free market' options.

The problem with the 'free market' in health insurance is that millions of people--anyone who currently or has ever been diagnosed with: cancer, diabetes, heart disease, multiple sclerosis, Parkinson's, cystic fibrosis, schizophrenia, muscular dystrophy, hepatitis, or paralysis. Almost all insurance companies also refuse to cover anyone who requires any assistance with basic daily living (that includes a large number of mentally disabled, as well as people who are blind, deaf, or have other diabilities) or anyone who must use a wheelchair.

So yeah, our system is great. Unless you have one of the following conditions or have a loved one with one of the following conditions. Then, if you lose your job, you are SCREWED!!

Good luck!

animalgirl
Look for one of the many states where an "uninsurable" person MUST be covered by insurance companies, albeit at a higher price, if the person can show he/she has been turned down by, I think, 3 insurance companies. I believe in these cases, insurance companies share a pool of insurance risk.

I know everyone thinks insurance companies are charitable organizations that should encourage people to sign up the moment they discover they're sick, but it's really, shhhhh, a spreading of risk, in theory voluntarily undertaken by insurer and insured BEFORE the need arises. The game would change significantly if we could all wait until we're seriously ill to buy insurance.

Sorry, you can either save your own money for future medical expenses, move to an accommodating state, or, gosh, move to Canada. I'm sure they'll be GLAAAAAD to have you. Or Cuba, where care is free and excellent.

Or spend all the money you have, then apply for Medicaid. No need to go without medical care in the U.S.

Remember a few years ago when someone--women? legislators?--someone was lamenting that women couldn't stay in the hospital for an extra day after they've delivered their babies? Notice how NO ONE ever thought to save up a few bucks to pay for her own room. Like, they don't know what's coming? They think their insurance company forbids their paying for an extra day themselves? If they can't afford to pay for a day or two in the hospital, what makes them think they can afford to raise a child?!!

oldsocialworker
Awwww, shucks.... :)

animalgirl
By the way, I've had brain surgery and though there's virtually no chance, at this point, that my tumor will reappear, I risk being "uninsurable" myself. I could even end up paying for my own medical treatment if something happens before I'm forced into Medicare.

Ya know, I can live with that.

I love this country!!

Medicare for all works!
Oh, puleeze, get it right about Canada. Their problem is not systemic, like ours, it is funding. They could increase their funding by 10% and totally eliminate their wait times and still only spend 11% of GDP compared to our 16%. But the right-wing Fraser Institute, which is funded by the insurance and pharmaceutical industries, will be the last to tell you that. Despite all of the horror stories, 80-90% of Canadians still prefer their system to ours.

That said, we don't need a Canadian system to provide healthcare. For the same 16% of GDP we are spending today we could provide first class care to 100% of our people. Sure, 80% of our costs are consumed by 20% of the people; they’re our seniors and end-of-lifers, the people regular insurers won’t treat. Perhaps we should start putting the old geezers to sleep when they start to falter. What the hell. But remember, that means most of us will ultimately make it to that list.

Or, we could just get rid of the waste in the current system. Over 30% of our healthcare dollars are consumed by the insurance bureaucracy without ever laying hands on a patient. This middleman and its highly paid executives and well-compensated shareholders are totally dispensable. But our politicians are on the take, and that industry funds much of their campaigns. So while they are getting fat off the system our citizens are going without healthcare.

The answer is a Medicare-for-all system funded out of general funds rather than by our corporations. Let them be competitive with foreign products that do not have health care built into them. And don’t give me all of this “socialized medicine” crap. Medicare is one of the most successful public-private enterprises ever. That it was just bogged down by a $780 billion pharmaceutical giveaway will be fixed as soon as we get the Dems back in control of the presidency.

In a sad twisted way the Dems maybe on
to something here.
I look at the current debate, and I find it very funny...Some of the very people who cheer for it the loudest are those who’s problem will be solved first. The very action of delaying services will solve many problems. They will be “taken care of”, their problems will be solved!!!
The normal waiting times for Non-emergency treatment experienced by the vast majority of Socialist countries in the west, Great Britain, Canada et cetera are the answer America needs.
The Social Security "retirement" age was originally planed so that only 1 of 7 people would ever get a cent. The current increases in the retirement age are attempts to restore that ratio.
On average the vast majority of medical costs happen in the last 18 months of a person's life.
Installing a Canada type system would practically save the US system. Not only would costs be greatly reduced, SS would also be saved... Of course it would kind of suck for those folks who are old, have chronic conditions, and so on.
And just consider the cost savings of reducing/slowing the care of for those children with expensive conditions.
I am sure the Government people would be exempt from the regulations.
Hilleray-care and the left’s embrace of Eugenics are evil, but it is a hard-hearted, god-free solution to many problems. This will help a lot of things. The costs will go down and that would leave a lot more resources for the healthy and the young. And the very victims of this system will be the ones begging for it to be done to them! Does it get any better than that? The left gets to exterminate the problems, without guilt, it will be fair, equal, and the exterminated people will thanks them for it!

Freemarket works for medicine...
1. Costs will be controlled by the market FAR better than any government/socialist/HMO system. Look at the cost of breast augmentation surgery or lasix eye surgery when those procedures first came out. (These aren't covered by insurance, as they are elective procedures.) The cost WENT DOWN and continues to go down, because the free market works!

2. If you think it is unfair for physicians to make the money they make, then may I heartily encourage you to get good grades in college, take the MCAT, get into medical school - and pay the $150,000 (minimum) to graduate, then complete anywhere from 3-7 additional years of residency/subspecialty training (where you make far less than the national average quoted above), pay the $1800-$3000+ fee and pass the exam required to obtain your national certification in your chosen specialty, then pay the licensing fees required by the state in which you plan on practicing. Then, as you are trying to support your family, AND pay off the medical school and college loans - remain calm when someone whines and moans and demands that your income be controlled by socialist government bureaucrats.

Okay, seriously now
I'd like to try giving the current car a tune up before I scrap it and buy a new one, especially one so very different that many other owners have complained about.

How to do that? Nothing that hasn't been said before. ERs should treat any emergency, even drug smuggling illegal aliens with a bullet in the tushie, but THAT'S ALL. They should stop being free clinics for the uninsured and illegal. Cut the bureaucracy. Reduce litigation risk with reasonable tort reform. Etc...

We won't really know whether the current system CAN work well until we eliminate the factors reducing its performance.

The Wisconsin fix
Peace_my_friend, costs likely will not go down if we switch to a Medicare-for-all system. But we will be able to cover all uninsured and underinsured for the same dollars we are spending today, which is about double Canada's and other countries.

Babydoctor, the free market is what got us into this mess in the first place, it will not get us out. The two examples you give are of procedures patients know they need and are elective. That's not the case with the other 99% of tests where the patient must trust the physician to diagnose.

I'll put my trust in elected politicians that get their healthcare from the same system as the voters, long before giving it to CEOs and shareholders whose bonuses and profits are based on how much they can get away with NOT providing. If you really want to see where the system is going if we don't fix it, see http://www.themonroetimes.com/v0814loh.htm

Physicians *should* make good money, and those in the top 10% should receive a 100% grant after completion (with progressively lower rebates as grades go down). But corporate medicine, where it's heading now, is not going to be fun. You best hope for a Medicare-for-all system where the elected politicians must answer to the public.

And Grumpy, under the Medicare system people will not have to go to ERs; they can now go to regular doctors. I agree that we need a 3-judge medical court system rather than the broken tort system.

We are working on a system in Wisconsin that would be a good national model. See: http://www.HealthyWisconsin.net

no bs artist
It depends upon where you live and what the illness is. If you live in one of the border states, there is indeed an increased number of Canadians seeking health care here. In addition , in order to remain fiscally solvent, Canada's system has srricter parameters around what is offered and to whom. For example, dialysis is not an option as a new treatment for 55+. I have chronic Lyme and have met a few Canadians who simply cannot get open-ended long term treatment in Canada (I don't live in a border state). These people have the means to pay, so they are getting treated. These are but a few examples.

We have open borders, attract legions of people who have enormous families, and encourage social irresponsibility at virtually every level. National health will be a trainwreck of unprecedented proportions. The fact that none of NH's proponents plan on participating in the system themselves should tell you everything you need to know.

Just do what is right
It's true, the U.S. has the best surgeons in the world. It's also true that if our physicians were trained in diet and nutrition/allergy that U.S. citizens would be a lot healthier, doctor visits would be down and pharmaceutical companies would be making billions of dollars less than they are now and.....America would be healthier.

It's true that a free-market system in health care can lead to corruption. (Think of an anesthesiologist who makes $18,000 on a weekend.)
Why is there so much obesity, chronic disease, auto-immune disorders and
repeated doctor visits/prescription refills?

Our doctors aren't trained to find the 'root cause' of health problems. They are trained to prescribe chemical-based pharmaceuticals which constitute one of the biggest and most lucrative industries in the United States. (Say what?)

Looking outside the box at bit, at what works in other countries doesn't mean the U.S. has to adopt social medicine. We can integrate what does work, and still keep patient's options open. There should some controls on physician fees, tests, procedures etc. and training.

Every U.S. citizen should have access and coverage for health care. The biggest joke overseas is that we don't care about our own people enough to treat everyone, only the ones that can afford it. And Michael Moore was right about that!


If you've never lived outside of the United States, you don't know that some doctors only schedule one person per every 20-30 minutes. Doctors also have simple blood labs right in their office where they can do simple tests right while you wait. They also have ultrasound machines in their offices which save you from having to pay again for an appointment in the hospital. And the doctor is trained to read the ultrasound.

We belong to a wonderful country. We've just forgotten how to serve patients needs vs. our
quest for acquiring what we think we deserve.
And that is what you call........pride and corruption.



Borders or not....
It is very clear that the globalization of jobs is going to change the way we deal with both health care and retirement benefits. It must. Our employers will not continue giving either one when they can simply outsource their work to foreign employers who don't. Since every other industrialized nation in the world provides some sort of health care, we must also (if we want to keep jobs at home).

So the question is: should it be a public pool or a private policy, and how long can we afford to wiggle out of making a decision?

The most practical approach for the country is a public Medicare-for-all, but the insurance industry will fight us all the way. Unless, of course, their campaign contributions win them the opportunity to continue ripping off the public with their Medicare Advantage program that gives them 20% more than traditional Medicare.

The simplest approach would be to get private money out of our public electoral system so politicians were free to fix it the right way, but that's dreaming. Our corrupt political system is going to be with us for awhile.

See http://www.healthcare-now.org/hr676.html

jlohman
Congratulations on Wisconsin's new, utopian Healthy Wisconsin experiment. And good luck to you, seriously.

I see that all residents will be getting "high quality" healthcare, a level that even insured individuals in other states are not guaranteed. Presumably all of your doctors, none of whom are of average or low quality, grew up in Lake Wobegone and moved to Wisconsin.

Who is it in Wisconsin who will decide what "good money" a physician may earn?

I also notice that, if you are working, you will only pay 4% of your income for your insurance. Do consider, however, that the 10.5% your employer will be assessed is 10.5% it costs him to employ you but which he will not pay to YOU but rather to the government.

The government, it appears, will not have that nasty bureaucracy that the insurance companies have and physicians & hospitals will have less of that burdensome paperwork; that will be wonderful. We can only hope that somehow they also manage to eliminate the corruption so often found in government (and those paid by government) so that their costs are actually less than those of a greedy insurance company.

Now that The Government has a stake in your health, it will be interesting to see exactly how they go about "encouraging healthy lifestyles." Will they ban tobacco, alcohol, skydiving, and other unhealthy and dangerous activities? Those who don't smoke, drink or skydive will certainly applaud their ban!

It IS nice that we have states that can conduct experiments on a smaller scale so that the rest of us can see what works. I assume your legislators studied Tennessee's failed plan and eliminated whatever caused Tennessee's failure?

Affordable (or free, for the children) healthcare sounds great. I hope that all of their cost & savings estimates and care promises are right on and the plan succeeds.

Call it what you want, Polly, but.....
As "utopian" as you may want to view it, roughly 2/3 of Wisconsinites support it, and that includes an equal amount of doctors and business leaders.

The 10.5% that businesses must pay is cheaper than the 15% for insurance premiums they currently pay, which in your words is an excess that cannot instead be used for wages. So they can now use that 4.5% savings for additional wages (which they likely won't, but they'll become more competitive in our globalized market).

The 4% paid by employee taxes is a savings over what they currently pay because it includes limited vision, dental for their kids, mental parity, pharmaceuticals, and the costs for a family plan (because 100% of the people are covered by the 10.5% and 4% taxes).

It's a good system for all but the insurance bureaucracy, because it is essentially sidelined and its 31% of waste is used to offset the higher level of care for all.

Note that it will likely not be perfect but it is an excellent starting point because it makes systemic rather than cosmetic improvements. The government is only involved in collecting the taxes and turning them over to a nonpartisan board for distribution to the existing private health care providers. Patients can keep their existing doctor or change if they like.

And our state legislators will be under the same healthcare system so I trust that the corruption and waste will be minimized (to the extent that politicians aren't involved in the corruption themselves, which is a never-ending battle with our moneyed -- and corrupt -- political system).


Continuation.....
But the government does not "have a stake in our health" to the extent that it can or will legislate against stupidity, like smoking, drinking and obesity. But it does plan a higher cigarette tax, sort of to pass some of that right-wing "personal responsibility" crap to the smokers that drive up healthcare costs. I would not even object if they had higher co-pays for obese patients, but there's that nanny state kicking in.

And for the record I do not have a dog in this race. I am on Medicare and "already have mine." But I would like to see this fixed for the sake of my kids and grandkids, because right now the future looks pretty dim for our country. You can see my personal disclosure at http://www.throwtherascalsout.org/disclosure.htm.

Access to a waiting list...
An unintended consequence of socialized healthcare in America would be lowering the life expectancy of Canadians. Our system, being relatively market-based in comparison to Canada's soviet-style scheme, is the only thing keeping a lot of our little buddies up north alive. Put another way, we can demonstrate "Love Thy Neighbor" simply by preserving the free-market aspects of our system.

Oh -- it also doesn't hurt Americans to preserve what works better than any socialized scheme yet devised. Ironically, a 2005 court decision (Chaoulli v. Quebec) loosened the government's monopoly somewhat, allowing some Canadians to purchase private health insurance. The court dryly noted that "access to a waiting list" does not equal "access to health care." How true.

Correct disclosure address is....

AudiR10 has it right
It's not free. It's never free. What foreign citizens pay for national health care comes out of their taxes.

I myself would MUCH prefer to pay for routine care out of pocket, directly to the physician or clinic, and maintain insurance only against catastrophic illness. That would save me a butt-ton load of money, and would be no harder to plan for than other predictable expenses. (E.g., I require an annual eye exam and a supply of contact lenses, which are not covered under my health plan. The cost runs me about $350 a year.)

I would also prefer to let the market set physician fees, rather than the state (i.e., through Medicare and/or state health insurance programs). I would prefer to let physicians allocate time to work pro bono for the community, as anyone who's been in a physician's family knows they do (and used to do much more often). Why it's better for the government to make it illegal for physicians to "discriminate" by charging some patients less than others is not clear to me.

I would prefer to reform liability laws to limit the idiotic proliferation of lawsuits that drives up malpractice insurance. A radiologist with 18 years of spotless experience practicing in central Oklahoma should not have to spend $40K a year in malpractice premiums in order to maintain privileges in the hospitals her practice is contracted to.

And I would prefer to provide health care for the indigent at the county or state level, paid for through local taxes and clearly a government-provided service – rather than organizing "private, commercial" health care to transfer money to the state to provide services for the indigent, but preserving, at great expense in bureaucracy, and the limiting of options for the solvent, the fiction that it is "free market health care."

GnuCarSmell....
>>> "….it also doesn't hurt Americans to preserve what works better than any socialized scheme yet devised?"

Well, if that were to describe the American system you might be right, but it doesn't. The World Health Organization has the US listed as 37th in the world in terms of effectiveness and efficiency.

Though we spend twice what every other system spends, we have a lower life expectancy and higher infant mortality rate that all other "socialized" systems. I think we are ahead in cancer but lag in all other areas.

And you folks keep referring to the Canadian waiting lists, which would not exist under a Medicare-for-all system that transferred our current 31% of administrative waste to patient care instead. At some point conservatives have to replace their ideology with pragmatism.

dyverje....
.... of course it's not free, but it is less costly than the current ripoff.

Paying out of pocket sounds just fine, unless you are low or middle wage with a family, and then the costs often deter needed care until it is more expensive to treat or becomes untreatable. Then you really do need your catastrophic coverage. My own daughter has such a plan and let her two kids go without care for colds, which my wife caught and she "toughed it out" even though she had Medicare coverage. So they ended up treating her for pneumonia, which was clearly less expensive than funeral services.

And just so you know, there is no such thing as "market competition" in health care. And if there were people would avoid the lowest bidders like a plague, figuring they were either physicians that couldn't attract patients or hospitals that lacked technology or cleanliness.

Insurance companies charge high malpractice "because they can," and I would certainly favor a 3-judge panel over our existing system.

It never ceases to amaze me how much work we are willing to put into avoiding to the right thing. I think it was Churchill who said "America will always do the right thing, but only after everything else fails."

So having a cold
is a reason to go to the doctor, as well as expect the neighbors to pay the expense?

Most younger people simply don't need anything more than catastrophic care policies. Colds and the flu are not life threatening unless there's a larger problem there to begin with. You can deal with it!

Call me negligent, but I don't take my kids to the doc every year apart from school-mandated athletic screenings because the fact is I don't need to drive up the cost of insurance even by such a little bit to pay for a doctor to tell me what I can obviously see for myself: the kids are just fine and are healthy as horses. Informal screenings performed at school for hearing and vision are good enough for us-if there's a question then we make an appointment. Dental and orthodontics are another matter but even dental checkups once a year are sufficient if you're making sure the kids are brushing and flossing and not pigging out on sugar.

There are, in short, many things we can all manage on our own without going in for every sniffle, bump and scrape. I liked the idea another poster had of basic care clinics. We have one in our town and it's a godsend.


jlohman
Bless your heart. You obviously don't understand that the REASON we don't have a free market in medical care is the government intervention we already have. Of course there's no market competition in physician fees. The vast majority of physicians find their fees governed by the state and its agents, the health insurance corporations.

Moreover, letting a market set prices is not tantamount to a race to the bottom in terms of quality of service. In the context of health care, it means letting physicians charge what they need to, to run their practices -- not telling them what they will be compensated for each service, and requiring that they charge that, and only that, no matter who walks in the door.

Demonstrating that each service provided meets state and insurance company criteria for care and compensation is an enormously expensive process that would be removed with the release of physicians' fees from regulation. Far fewer people would need to be employed in health care management, which would cut the price of the actual services dramatically. We are not paying for health care with our individual expenditures -- we are paying for REGULATED health care, and that's why it costs so much.

Learning from Great Britain
To get a glimpse of the long-term effects of socialized medicine, consider Britain's National Health Service. After the NHS took over, Britain opened fewer hospitals in the next fifty years than it had opened during the 1930's -- and that was during the Great Depression. Those that still operate are often poorly maintained, filthy and produce one of the highest rates of hospital infection in the world.

As a result, many Brits do what Canadians do -- they go elsewhere for treatment rather than languish on a waiting list. India, especially, gives sick Brits a chance to stay alive since the NHS often won't.
http://www.thefreelibrary.com/Health+of+the+State%3a+doctors%2c+patients%2c+and+Michael+Moore-a0166991202

AliveInHim....
Glad to hear you have your medical degree. You certainly need it with kids. But you obviously did not understand what I said: my wife did not run to the doctor with her cold and paid the price with pneumonia. You obviously would have been much better at diagnosing the ultimate outcome.

You also miss a very important point: co-pays or any other means of "sharing the expense" has proven to cost more than it saves, both administratively and in egregious outcomes. According to studies by the Rand and Kaiser Foundations, high deductibles can deter care until it is more costly to treat or becomes untreatable. Mothers will opt to put food on the table before buying their blood pressure medicine, and then they'll have a costly heart attack or stroke, or worse, die. We can do better.

Medical Tourism
Google "Medical Tourism" for some interesting reading. It seems that many, many Americans are going abroad for quality surgical and medical treatment at prices much lower than in the United States. And, BTW here's a prediction: if the Right Wing succeeds in overturning Roe v Wade, we will see a stampede at the airports. There will be package deals including airfare, transfers, basket of fruit, tour of the city, and an abortion.

A personal note: while attending a scientific conference in Copenhagen, Demark, my husband became severely ill. He was taken by ambulance from hotel to hospital where he was kept on bedrest for two weeks and his infection was treated with antibiotics. His bed had a down comforter and he was given beer with his meals. The food was excellent, as were the nursing and medical care (the whole staff spoke English). When he was discharged he was presented with a bill for $30 and apologies that his entire bill could not be covered as he was not a Danish citizen.

To dyerje
About ten years ago I had a minor surgical procedure that I had often had before. The doctor I was going to was very much a free-market Republican, in fact he ran for Republican office several times and had pictures of Ronald Reagan all over his office. Private practice; small private hospital where he was a big shot. He insisted the procedure could be done only in a hospital operating room even though I told him I had had it many times in doctors' offices. So I had to do it his way. His fee was $650, the operating room cost $1400, and there were many peripheral hospital fees (recovery room, X-Ray doctor, anesthesiologist standing by although never used, etc).

About a year after that I switched to a doctor in the same specialty who was on staff (a salaried full professor) at a major university medical center. Not private practice. Professionally, he far outranked the first guy. He did the identical procedure, in his office just as I had had it many times before. It took five minutes after which I went shopping. No big deal. When the bill came it was for $125.

Free-market capitalism is fine, but I don't want it running my medical care.

To ARby
A caveat: I read an article the other day about how the McDoctors (little walk-in centers you spoke of) are over-prescribing antibiotics for a quick fix. Not good as you can build up a tolerance then when you really are hanging by a thread the drugs don't work.

priorities
In Canada it is bureaucrats who decide what to prioritise. Twenty nine years ago in Winnipeg you could get a taxpayer paid for sex change operation. You may have to wait 5 weeks for a cancer specialist but you can get "FREE" sex changes. Is this what America wants?

Free sex changes?
Oh how stupid. Of course a public system shouldn't pay for sex changes or cosmetic surgery or boob jobs, but what makes you think that some of this is not already covered by private insurance and you "the sky is falling" predictors are not already picking up the tab?


jlohman
If antibiotics were prescribed for every person with a cold, we would soon develop strains of bacteria that laughed at existing antibiotics. Which would require that pharmaceutical companies seek new antibiotics that would destroy these new, stronger bacteria. Which would cost billions of dollars, assuming they could even successfully develop them (it's not guaranteed, you know). Which would make everyone angry at the greedy drug companies--again.

This is why doctors advise people to NOT see their doctors for a cold. Colds are caused by viruses, viruses aren't affected by antibiotics.

I'm afraid people really need to wait and see if their colds progress into bacterial pneumonia, which they usually do NOT. Your wife did the right thing, though she may have waited too long to seek treatment.

Polly
Yes, Polly, she waited too long. But how long is too long, and when should she have gone? It's immaterial now.

The bigger issue is the life threatening situations that occur when mothers forego blood pressure medicine because they can't afford it. And then they die or have a more costly stroke or heart attack. Of course the insurers prefer that they simply die and are off the system.

The bottom line is that for the same health care dollars we are spending to provide health care today, we could provide first class care to 100% of our people. That, rather than sending unneeded funds to the insurance bureaucracy that supports 1500 insurance companies in the US. When in fact we need none of them if we were to do it more efficiently. No corporate leader in his right mind would design a system the way ours is today.

But we are stymied. Some of the folks here are ideologically hung up on the government being able to do anything right, and would rather put their lives in the hands of corporate CEOs and shareholders. Others are simply industry hacks who are willing to argue against anything that might replace their positions in the marketplace.

So the politicians have to exert themselves and do what is right, yet that is even hard when they are getting campaign funds from the insurance industry.

Lilly was just in time
P.J. O'ROUKE - "If you think health care is expensive now, wait till you see what it costs when it is free."

My girlfriend’s Swedish 82 year old brother in law has had some severe pain in his neck and behind his eyes for 5 years. We suggested an MRI. He said that they refuse to do one. Her sister once scheduled a painful foot needed operation 1 year in advance.

Sweden’s has cut their medical and social entitlements after the left wing was deposed from 40 years of power. It has since gone from 17th richest and freest in the world to 12th. Their currency has almost doubled to the dollar. Sweden was once the medical wonder of the world and the 3rd richest nation before it headed down the Marxism road to death.

Anyway, Lilly I’m glad your husband was able to get in under the wire for “free” health care at the expense to the Danish taxpayers. I had a client that always scheduled a hospital room for business stays in China. It was cheaper and better than a hotel room. These examples are merely giver-ment misallocating resources from their proper cost thereby encouraging abuse and leaving the taxpayer with the “free” bill.

Oh, Lilly, Denmark just reorganized their medical system and targeted their hospital cost problem as enemy # 1. In fact in March this year 55 of their politicians visited Kaiser Permanente in CA to figure out how to cut this boondoggle down to size. IT DID’T WORK.

My solution is the following to make everybody happy. Lilly and fellow travelers pay for “free” giver-ment health care and only they can use the system. All others don’t pay a tax for this and they pay their own cost. The left wing save money with free health care and the self reliant save money in tax reduction. Win, win.

Yes, ha ha...
P.J. O'ROUKE is a very clever comedian, but probably has all the healthcare he needs. He is totally disconnected, so I wouldn't look to him for real-world solutions. Unless, perhaps, he is willing to give up his Cadillac system and join the rest of us.

And yes, I waited for two months just to see an orthopedic surgeon, and another two months to see an eye doctor. And that was in the US!

But tell me, Deskjockey, which insurance company do you represent? Or are you one of those indestructibles that will never get sick, never have a car accident, never catch a communicable disease, and have just perfect genetics? My, you are lucky.

Sweden
And wow, deskjockey, I never realized that about Sweden. Here's a group that surely doesn't know what it's talking about; they have Sweden listed as second and the US as sixth highest standard of living in the world: http://www.mapsofworld.com/world-top-ten/world-top-ten-quality-of-life-map.html

And are you really sure that the Swedish currency rose in comparison to the dollar, or did the dollar sink (as most economists believe)?

We sure can believe what we want to believe, can't we?

lilly
I wonder if you were hog-tied or forced at gunpoint to accept the dictates of the original doctor in your story?

Somehow I doubt it. I don't know all the particulars of your case, so I'm not prepared to judge what happened. But even assuming the first doctor was trying to gouge you, it's clear that you had another option all along. You just didn't elect to use it.

There's nothing at all wrong with a patient, especially one familiar with a procedure, looking for a second opinion or a preferable treatment. It's not the fault of that first doctor that you didn't use this option, any more than it's the fault of a salesman if you pay $5K more for a car than you had to, by choosing not to negotiate.

The difference between your case and nationalized health care is that under national health care, you WOULD NOT have the same option you had here.

Jlohman
I'm sorry for your wife's illness, but the fact remains that most people do not need to go to the doc for every little thing. I myself am susceptible to upper respiratory troubles and usually wind up with a wowser of a cold or the respiratory flu once a year. I had asthma as a youngster, again as a teenager, and expect I may well struggle with other things as I grow older. No, I don't smoke.

But you don't need a medical degree to know that most minor illnesses can be got through without the help of a doctor. My kids NEVER had the number of bronchial infections my best friend's kids had; they were always getting antibiotics for this or that. Her kids were in daycare, mine weren't; that may well have been a factor. But as Polly said, too much anti all the time can lead to resistance. Yes, we could and still do count on the yearly cold/respiratory flu, but you really don't have to be a genius to see when things aren't progressing as they ought.

Our health insurance has the copays to be sure, but that $30.00 out of pocket is not a justification in my mind to go all hypo with the health thing. My husband who is president and owner of a fuels company is considering the HSA alternative; the costs of the insurance we now have is thru the roof precisely because the employees don't pay for it so off they go for the least little procedure.

Wrong....
Under national health care Lilly still would have been able to select a greedy doctor. They have CPT codes under which they bill, and he found a code that gave him more money. But Lilly's case demonstrates several points: that (a) even under a free market system there will be greedy doctors and (b) patients are not in a position to second-guess the doctor. Maybe in great hindsight Lilly will avoid him again, but even a second opinion at the time would not necessarily have saved her from the extra odeal.


jlohman writes:, 02, 2007 6:29 PM

Deskjockey, which insurance company do you represent? Or are you one of those indestructibles ……

DESKJOCKEY RESPONDS

I represent no insurance company or other health business. Insurance should be a defense against catastrophe not an installment payment plan. I use a high deductible to get the insurer's negotiated fees but end up paying my costs out of pocket unless I have a catastrophe.

I have no family doctor.

Now a couple years ago when I fell off the roof and broke many of the bones on one side of my body, I decided not to go to the doctor. My girlfriend came over, took one look at me while I was still somewhat conscious and called the hospital and they said come on in now before he bleeds to death. If she hadn’t come over I’d have tried to have made it through the night to see how I felt the next day. I don’t go to the doctor for anything unless I think death is within hours. I know this is bad policy and common with males, but I look at the medical profession as a luxury not a right, and a dangerous luxury that often does more harm than good.

Clearly certain cities can have waits in the US because doctors choose not to work there. Therefore you need to fly or drive to a city that attracts doctors to get instant care. In my city if you don’t have an emergency you can find a doctor with 1 day - 2 weeks wait. If you think it is important you can get in immediately.

If we take all the hypochondriacs that get to indulge in their predilections at taxpayer expense out of the system, doctors would start coming to your house again as they did when I grew up. 95% of the demand is false demand that the third party pay systems fosters.

jlohman writes, 02, 2007 6:55 PM

Here's a group that surely doesn't know what it's talking about; they have Sweden listed as second and the US as sixth highest standard of living in the world: http://www.mapsofworld.com/world-top-ten/world-top-ten-quality-of-life-map.html

And are you really sure that the Swedish currency rose in comparison to the dollar, or did the dollar sink (as most economists believe)?

DESKJOCKEY

Not only is it instantly apparent when we visit there but when they visit us and their shock about the wealth of the US. My girlfriend’s brother was upper mgmt. for Saab handling sales for Europe. I could fit his house in my courtyard. He does own a tiny condo in Spain and a Saab car. The 82 year old I mentioned earlier was a training exec for IBM and also played in a band nights throughout his career and lives in a 600 sq ft condo. His counter part (deceased) lived in my town in a 2,800 sq foot home, had two cars, investments in stocks and real estate and didn’t have a night time job and his wife never worked.

You are correct that your group doesn’t know what it’s talking about and they admit such. Your website from India, chairman is Simarprit Singh and he says, “However Compare Infobase Limited, its directors and employees do not own any responsibility for the correctness or authenticity of the same.” This is quite different than the Cato Institute and the Heritage Foundation that take full responsibility for their representation that Sweden has moved from 17 to 12.

Being an AmeriKan, I can only apply the principles of Einstein’s relativity and the Krona rose relative to my position. It has taken much of the fun out of my summer visits when the dollar was much higher and things were cheap. Not being an AmeriKan one might consider the dollar changing compared to their currency, however the dollar being the dominant world currency, others would correctly move according to it, not vice versa.

Deskjockey
So you could have died because you avoided care and your girlfriend's fortuitous visit triggered a potentially life-saving vist to the ER? You made my point. Hypertensive patients have a 10% higher death rate when they in a high-deductible plan.

According to the Bell Policy Center "HSAs coupled with high-deductible health plans increase cost-consciousness among enrollees, but have little effect on overall health care costs." See http://www.thebell.org/PUBS/IssBrf/2007/08-HSAs.php


monticup
Canadians pay cash. Doctors in the USA are delighted to see us.

Almost everybody here who can think understands and admits that the only thing making Canadian healh care still work is the fact that 80% of the population live within 2 hours of the US border.

The biggest problem we have in Ontario is that we are forbidden by law to buy private insurance. Only 3 other countries have this policy: Cuba, North Korea and Albania.

AudiR10
In a recent survey of 18,000 Canadians, only 20 -- TWENTY -- came to the US for care. If you are a Canadian you should demand that your politicians increase funding. Just 10% increase, to 11% of GDP, would eliminate your wait times and give you first-class care. But the Fraser Institute (that is funded by the insurance and pharmaceutical industries) is lobbying your parliarment to do just the opposite.

jlohman
Ah ha, you're still here!
It occurred to me that if I knew your theoretical woman, the one who had to choose between her blood pressure medicine and food for the children, then 1) if it were my sister or a close friend, I'd help her pay for her blood pressure medicine and take care of the kids when she went to the doctor; or 2) if it were a stranger, I would inform her about the drug companies' programs that provide free drugs to those who can show need. The programs exist, and I'm surprised so many people don't know about them, especially since I've seen many ads on television lately--by drug companies--explaining the programs.
(I probably would NOT tell her to avoid having more children, since she can't afford the ones she has.)

Polly
The studies I refer to were done by the Rand and Kaiser Foundations, and patient privacy laws would likely prohibit the passing of names to you. But I'm sure these women would just love you for your offer anyway. Yes, drug companies are very adept at getting brownie points on the air, and so was Philip Morris when it aired ads telling kids not to smoke.

But you and the others must ask why you are justifying the 31% of insurance industry waste, when we could be spending it for patient care instead.

Oh, all right, let's also find some way that we can punish the lower wage earners for not making more money, and enough to be able to afford the unreasonably high costs of health care. Surely we must be able to cast stones at them while we let the greedy CEOs and shareholders off scot free. I know I'm not very creative in this arena so I'll have to leave it to a compassionate conservative to do so.

One person's perspective
The US healthcare system is broken. The Canadian healthcare system has huge problems. Nothing's perfect.

All in all, after experiencing service in both the US and Canada (as a resident in each), I would gladly choose Canadian care over US care.

Here are the reasons:

1. Walk in clinics- I can get non-emergency care anytime anywhere in British Columbia (wait times tend not to be long and they are open late in urban areas). No cash is handled anywhere on the premises.
2. Emergency care is fast and professional (no difference from the US in my experience).
3. More emphasis on alternative care and preventative measures. For my wife's pregnancy, we chose a mid-wife and (based on talking to pregnant friends back in the states), we are getting better care without being charged any extra $$$.
4. Because it is well known that the homeless guy shooting heroine on the street has the same insurance that I do, there is generally more attention paid to reduce and prevent harm. Thus, costing less. A good example is the safe injection site in downtown Vancouver, which has saved the provincial government hundreds of thousands of dollars in reduced emergency care costs.

One person's perspective part II
Of course, the US has more capacity, but it has to be paid for. One way or the other.

The biggest hardship I've had so far was that I had to wait 4 months for elective, but essential eye surgery. But, that's nothing, really.

Oh yes, and an in-law did go to the states for a hip replacement. She could afford it, so she did. It was a non-emergency, but she wanted to get her quality of life back. How is that different from the states? Those with more money get better care?

One more anecdote: Both of my grandfathers passed away due to complications from hip replacements. Neither were wealthy. Both went to a regular hospital and both got staph infections that eventually killed them. Would their outcomes have been different if they paid out of pocket for extremely good care like my in-law? I don't know, but I wouldn't be surprised.

oops..forgot to mention
Both of my grandparents received their fatal care in New York City.

"health care"
Repeat after me, there is NO RIGHT TO Health Care, unless YOU pay for it, not the gummint, not insurance companies, not your employer... the gummint and insurance companies are a serious contributor to any "problem" we have today... Phooey on socialism, phooey on social medicine, and phooey on those socialists and Hilaryophiles... go to Canada, go to England, or go too Koobah.

Gee...
It is really nice when someone adds some intelligence to the discussion. You can put your teeth back in now.

Andrewe
Given your grandparents' fatal hospital-incurred staph infections, do you shake your head a little when you hear demands that new mothers be allowed more days in the hospital? With their fragile new-born babies?

jlohman
Golly, now you think it's wrong for drug companies to advertise that they will supply drugs, for free, if you can't afford them. I wonder how you think poor people should find out about these programs? (The Government, I presume.)

I recently heard an ad, starring a cheerful old woman who was able to play with her grandchildren--know why?--because she got good, nutritious food with FOOD STAMPS, thereby keeping her body strong enough to keep up with those grandchildren.

So the Government, too, is advertising free stuff, begging to give it away, hoping you won't feel embarrassed to take it. One major difference, of course, is the Government (which essentially produces NOTHING) is giving away the TAXPAYERS' stuff, whereas the drug companies are giving away their own stuff, stuff that could otherwise go to greedy CEOs and greedy stockholders. Yes, shame on the drug companies. They should keep these deals secret.

Polly
Just how many people do you think the drug companies are going to let into their "free" program? All that need it? Don't kid yourself. They will have a few "poster children" and that's it.

I have mixed emotions about drug company advertising. In some cases patients are alerted to early warnings, and in other cases they subvert the doctor's guidance, and in still other cases rightfully so. But in all cases the advertising costs are borne by the patient.

You should read Dr. Angell's excellent book "The Truth About the Drug Companies: How They Deceive Us and What to Do About It." There is much you need to know about drug companies that you'll find here.

And if you really want the government to stop giving away taxpayer assets, demand an end to the political corruption. See http://www.wicleanelections.org

jlohman
The theory that "in all cases the advertising costs are borne by the patient" presupposes that advertising does not increase revenue. In that case, just about anyone who advertises anything is only screwing their stockholders and their customers, not to mention interrupting my television viewing. Perhaps we can get Congress to outlaw advertising (they've made a good beginning with McCain-Feingold).

I don't have stats on exactly how many "poor" people they will dispense free drugs to. Do you? If not, why do you assume it's a limited program? Was it "in the book"?

I've actually never seen a "free drugs" patient extolling the virtues of X drug company, so how exactly are they using these people as "poster children"?

And GOOD LUCK on that "ending political corruption" thing. As long as MY dollars can buy THEM votes, they'll be giving them away. And as long as they can steal with little chance getting caught, well....

Bridge to Nowhere or Massachusetts' Big Dig, we're all in it together. They never have enough money, yet they always have enough money for, uh, earmarks.

Polly
I object to politicians who work for "us" but get money from "them." As a former CEO, if I had a purchasing agent taking money from vendors he favored with my company's business, I'd at least fire him and even try to have him jailed for fraud. Under our current political system we just re-elect the bastards.

But the public doesn't tend to connect the dots. We could totally fund the congressional elections for $10 per taxpayer per year and in the process eliminate the $300 billion in subsidies and pork that calculates to $3000 per taxpayer per year.

Go figure. We have blinders on.

jlohman writes:, 03, 2007 6:09 PM

So you could have died because you avoided care and your girlfriend's fortuitous visit triggered a potentially life-saving vist to the ER?

DESKJOCKEY RESPONDS

YUP


jlohman writes:
You made my point. Hypertensive patients have a 10% higher death rate when they in a high-deductible plan.

DESKJOCKEY RESPONDS

They could afford a lower deductibles if the giver-ment left the system thereby removing huge false demand that is driving up prices.

My point is simply that I, not the giver-ment, should decide if I want to purchase medical care. There are risk to getting on a plane, driving a car and getting out of bed, and I’m willing to take those risks. I do not see the function of giver-ment as protecting me from myself. I believe I have no God given right to steal your money for my health care, food, shelter, education, clothing and transportation nor a right to demand giver-ment steal those items from you to give to me.

jlohman writes;

According to the Bell Policy Center "HSAs coupled with high-deductible health plans increase cost-consciousness among enrollees, but have little effect on overall health care costs." See http://www.thebell.org/PUBS/IssBrf/2007/08-HSAs.php

DESKJOCKEY RESPONDS

Simply stop taxpayers subsidizing company health insurance. When the taxpayer is paying half the cost of others health care it creates false demand. Worse yet, it lets the doctors bill like crazy for procedures never done or completely unnecessary. When you pay your own bill you are very careful what you are paying for.

I have achieved a modest degree of wealth in life with several simple ideas. One is simply, can I live for the next 30 days if I don’t purchase this item or service.

I suspect that 95% of doctor visits are a waste of time and if the folks waited 30 days they’d never need to go. I nursed one for 2 years and it finally healed without surgery.

jlohman writes:, 03, 2007 6:09 PM

So you could have died because you avoided care and your girlfriend's fortuitous visit triggered a potentially life-saving vist to the ER?

DESKJOCKEY RESPONDS

YUP


jlohman writes:
You made my point. Hypertensive patients have a 10% higher death rate when they in a high-deductible plan.

DESKJOCKEY RESPONDS

They could afford a lower deductibles if the giver-ment left the system thereby removing huge false demand that is driving up prices.

My point is simply that I, not the giver-ment, should decide if I want to purchase medical care. There are risk to getting on a plane, driving a car and getting out of bed, and I’m willing to take those risks. I do not see the function of giver-ment as protecting me from myself. I believe I have no God given right to steal your money for my health care, food, shelter, education, clothing and transportation nor a right to demand giver-ment steal those items from you to give to me.

jlohman writes;

According to the Bell Policy Center "HSAs coupled with high-deductible health plans increase cost-consciousness among enrollees, but have little effect on overall health care costs." See http://www.thebell.org/PUBS/IssBrf/2007/08-HSAs.php

DESKJOCKEY RESPONDS

Simply stop taxpayers subsidizing company health insurance. When the taxpayer is paying half the cost of others health care it creates false demand. Worse yet, it lets the doctors bill like crazy for procedures never done or completely unnecessary. When you pay your own bill you are very careful what you are paying for.

I have achieved a modest degree of wealth in life with several simple ideas. One is simply, can I live for the next 30 days if I don’t purchase this item or service.

I suspect that 95% of doctor visits are a waste of time and if the folks waited 30 days they’d never need to go. I nursed one for 2 years and it finally healed without surgery.

No such thing as national health care

You will not let the giver-ment redistribute your money for somebody’s new car, taking an extra week of vacation, working only 10 hours a week, buying Nikes for the kids, sending the kids to summer camp. So giver-ment tells its voters, I’ll steal money for you but I won’t tell them what you want it for, I’ll tell them that it is to keep you alive. Certainly nobody will mind having his money stolen to keep you alive.

So, buy that new car and instead of paying for your health care this year, I’ll steal the money from your neighbor to pay for your health insurance. My slogan is vote for me get your new car for free.

Health comes before food, housing, utilities, clothing. If you are in great pain, all you want is for it to stop, not a new dress, or steak dinner. Therefore it is the first dollar you will spend. If I pay that for you, then you free your dollars up for your wish list. All entitlements are merely money for a new car or longer vacation, never the phony reason given that would be covered by your first dollars.



jlohman
When most Americans would rather watch "American Idol" than any political program, even the liberal programs, when they're unlikely to read anything more informative than "People Magazine," there is NO way they'll ever rebel against the corruption that is D.C.

And even those Republicans who were elected to Congress pledging to carry out The Contract with America soon fell into the pattern of the corrupted, powerful elite in Washington. I do believe they had good intentions--way back then. Proof of the truth that "power corrupts."

"Government"-funded elections would only lead to more-certain re-election of the incumbents, who've used our money to build goodwill and name recognition all through their terms.

I see no way to fix it. It makes me very sad and not a little angry.

Polly
Actually, Arizona has had great results with theirs, and more third-party candidates are running because they get the same money to campaign on as do the two major parties. Roughly 70% of their elected people take no private money at all, including their governor. Maine has worked equally well. Here are the stats for AZ:

http://azclean.org/documents/8-9-042002SuccessStats.doc

jlohman
Maybe it's because it's late but I couldn't see exactly how much better the Clean Election plan worked. Maybe many third-party candidates ran but it didn't seem that any third-party candidate won.

States are so different from the feds. They don't have the incomprehensible pile of money to loot and might even tend to spend responsibly. For the feds, ALL THAT MONEY, unimaginable numbers, so easy to waste it.

Polly
3rd party candidates were able to run a credible race and made the field more competitive. That they did not win means they were not as attractive to the voters. But that will change.

The real advantage is that they get their campaign money from the Clean Elections fund and are no longer obligated to the industries that seek subsidies and pork. In Wisconsin that would reduce our state spending on giveaways by about $1300 per taxpayer, all for an investment of $5 per taxpayer.

It would work at the federal level too, and there is a bill by John Tierney to implement Clean Elections. To be constitutional the candidate must be able to opt out and about 30% do. But smart voters won't vote for them.

A case in point (just one of thousands) is a shipbuilder in PA (Flagship) gave Arlen Specter $8500 and got a $40 million contract to build ships the Secretary of Navy said they didn't want. The public would hav been better off giving Specter the $8500 directly and saved the $40 million in waste.

jlohman
Oops, "But smart voters won't vote for them."

They can still win by a landslide.

Polly
But in the states that have Clean Elections (Arizona and Maine, but more recently CT and NC), smart voters *have* ousted the conflicted politicians and have legislatures now made up of 60-70% of Pols that ran "clean." It's a hell of a good start, and it means that special interests will have a very tough time getting through spending sprees.

jlohman
I still believe that states, with their comparatively puny little treasuries (and their huge needs for infrastructure maintenance!), and often limited ability to borrow, are not as big a problem as D.C., with its virtually unlimited taxing, borrowing, and spending abilities.

Corruption found at the state level is usually quite small by comparison (and easier to uncover).

Polly
I agree, and at the federal level the stakes are much higher, the payoffs much greater, and the corruption is out of sight. We are nonetheless pushing on both fronts in the hope that the positive experience at the state level will force a national solution.

I don't want to use this blog to hawk my book, but if you communicate with me by email I'll send you a complimentary copy of it. It is not a pretty picture ahead of us.

Jack Lohman
jlohman@execpc.com

You can see the book at http://www.moneyedpoliticians.com or my web site at http://www.throwtherascalsout.org

chicaree
About the kids going deaf because their parents can't afford the Dr. fee is crap. If the parents take the child to an emergency room they will be treated and the money will be straightened out later. And virtually every hospital in the US has one or usually more programs to take care of those in financial need. If the parents won't take their children in for care it is because people like you spread this disinformation and cause them to believe there is no help for them. I feel that if you are spreading this crap you are doing it knowingly and you are the people who are responsible for the children's deafness. So if you want to do good then quit lying to these people and start getting them to go to the people who will help them.

chicaree
About the kids going deaf because their parents can't afford the Dr. fee is crap. If the parents take the child to an emergency room they will be treated and the money will be straightened out later. And virtually every hospital in the US has one or usually more programs to take care of those in financial need. If the parents won't take their children in for care it is because people like you spread this disinformation and cause them to believe there is no help for them. I feel that if you are spreading this crap you are doing it knowingly and you are the people who are responsible for the children's deafness. So if you want to do good then quit lying to these people and start getting them to go to the people who will help them.

jlohman
I see you are still touting the one thing we have a major difference of opinion on. You know what I have done to take care of my medical care. Do you think that can't be transfered to the general population in a matter of a few years? If the government were to educate the citizens on how these types of programs are set up and how they work then set up a system to help people successfully do them (with appropriate safeguards and a backup to take care of catastrophic costs while they were starting out) wouldn't that be a better long term solution?

freedom
I realize this is a bit off topic, maybe. What is your definition of freedom? Let me know and I will give you one that will make you ponder for a bit

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

jlohman
I fail to see how you put me in your YOYO category. What I have done for myself would be very easy to implement on a national level and it would keep the government out of the health insurance business while empowering our citizens by giving them something they would own and would provide a model for a replacement system for social security that would not end up being a slush fund for government corruption. It could be integrated into our society 100% in one generation. You didn't answer the question BTW.

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

snake0311
Well, I don't particularly care that we disagree on this. One author put our population in two categories. YOYOs and WITTs. YOYOs are "You're On Your Own" types. I've got mine and you get yours, if you can. They don't have a problem with the fact that the rich are getting richer on the backs of the poor.

WITTs are "We're In This Together." Not bleeding hearts, but also not cruel. They see a need in helping others, like universal health care.

I know what category I'm in, and I feel good with it. When I was in business and a client hit hard times I was always the first to say "let's write it off." YOYOs would take them to court. But as CEO I always got my way.

How does it feel to be a YOYO?

Sorry folks
Wow, sorry folks. The Townhall blog software is apparently screwed up and is multiplying my posts.

jlohman
Now that looks more like a YOYO to me. Would you read my last post and comment. It is back up in the middle of your barrage.

snake0311
Your last post seems to say that you are great and you don't see why the rest of the population can't also be. Am I correct?

If so, it has been adequately shown that 80% of patients are not knowledgeable enough to control their own medicine. Good luck on teaching them.


jlohman
You haven't quite got it. The government could help people set up plans similar to mine and help them become more independent instead of being more dependent on the government for handouts. If the program is set up properly it would eventually become self supporting. The children being born now would be the first ones that would have an account basically from birth. The money required to do that would be very small compared to starting one when they reach working age and could be funded by using a part of the deduction for a child to start the account. These accounts would be specifically for the named person with ways to pass them on to their heirs (that is the self supporting part of it). There would have to be safeguards to prevent the government from raiding it like they do with social security. I could go on but this should give you the idea.

Canadian Health Care
I am curious, if the Canadian system is so bad, why is it so heavily utilized that non urgent care takes about the same time to get as it does in the US? I have a friend with a degenerative bone disease, he has had replacement surgery for both knees and both hips. The process took over two years. Some of it was "healing time, the second hip. All the rest of it was "waiting" time for an open appointment. This is not in Canada, it is in Texas, and fully covered by health insurance. What it means is he paid premiums that total about a tenth of the cost of one surgery, and the other people in his insurance pool, paid the rest of the cost. That's right, the OTHER people, the ones who don't need surgery paid, just in case they might need surgery about 200 dollars a month to cover the cost of this young man's joint replacements. Canadians pay far less than 200 dollars a month for coverage, and everyone has it.

Your argument that the Canadian System is not cost effective falls apart as soon as the cost of insurance premiums is considered. Automobile insurance in the US includes a huge bite for accidental injury coverage. About two thirds of the premium, on most policies, would disappear with a national Health Care system paid for through taxes. The auto insurance company would not be paying the bill, the health plan would be.
How much medical care have YOU received after an auto accident, and how much have you paid for through your premiums? How much health care has been delivered to YOU, and how much have you paid for it through either lower wages or premiums?

snake0311
You are talking basically about a health savings account. What happens to all of these peoples' health care if the market or economy crashes, which is going to happen in the next few years (if not this year)?

It never ceases to amaze me, the amount of energy that can go into a project just to avoid doing the right thing. The best, simplest, least costly, most effective thing we could do is expand what has been working so well for years, Medicare. You get sick, you get care, and the caregiver gets paid. Nothing could be simpler. But follow the money and you’ll find why the politicians don’t like it.

jlohman
This is not an HSA. It is a different vehicle entirely. Even during the great depression mutual funds still made money and the average return on them from when they were introduced about 90+ years ago has been around 12%. To date I don't believe a single mutual fund has gone under

snake0311 writes: , 07, 2007 9:37 PM

.... To date I don't believe a single mutual fund has gone under.

DESKJOCKEY RESPONDS

They do go under. Remember Bernie Cornfeld among others. Also, I suspect very few have averaged 12% for the last 90 years and would put that number somewhere between 0 & 5.

Deskjockey
I stand corrected about the failure of funds though there have been practically no failures that weren't the result of fraud or gross mismanagement. Mutual funds, by their construction, don't go under easily. That would require a minimum of 20 stocks and/or bonds to collapse at once. Most mutual funds have many more than that and the fund manager is constantly changing the composition of the fund to optimize its performance. Companies that manage these funds do go under and other companies tend to pick them up and continue to manage them.
An average of 12% is valid and of course not all of them do that because an average is the overall performance of ALL mutual funds of all levels of risk. By managing the risk levels you expose yourself to and keeping a good variety of funds in your portfolio you can produce fairly consistent long term results. Mutual fund investments are not get rich quick things, they require patience and time to produce results. BTW the SEC regulates the funds sold in the US very strictly. Cornfields business was based in Europe.

What goes up does come down.
My family got a few cents a share on some funds closed out in the early 70's. I ran a very very small fund in the late 60s that I closed down in ’71 and then joined what is now UBS. In just one year 2/3rds of all brokerage houses closed.

I suspect 12% over the past 90 years to be mutual fund hype, do you have some data? Does your number include the funds that closed or only those that continue to operate? For example the Dow Jones only includes those still going but ignores past listings now bankrupt. It skews the facts of true results.

snake0311 writes

By managing the risk levels you expose yourself to and keeping a good variety of funds in your portfolio you can produce fairly consistent long term results.

DESKJOCKEY RESPONDS

Seems reasonable and prudent.


snake0311 writes

BTW the SEC regulates the funds sold in the US very strictly. Cornfields business was based in Europe.

DESKJOCKEY RESPONDS

Bernie, who grew up in Brooklyn, made his money by targeting US soldiers mostly Germany, and other Americans living in Europe, not Europeans. It wasn’t fraud per se that brought down so many funds in this era, but rather that they held a lot of unlisted stocks (no market). IOS had a large component of such. Many if not most American funds also had this problem. I believe today you can’t have more than 5% if not less. Because a portion of the portfolio wasn’t liquid, when redemptions went up the funds folded. Grab a WSJ for 1970 – 74 and look at the mutual fund section and see how many are still around. Also look at the prices. I suspect during that period there may have be 1% of fund owners at a profit. It was very ugly.

Since the mid 70’s, it has been wonderful on Wall Street, but trends ebb a flow.

Another quick thought

The reason so few had a profit in funds in the early 70s brings up another representation issue. A fund sells 1 share total and that one share goes up 100 fold in 5 years and the guy has turned $1 into $100. It then shows this record and attracts $50M and the fund falls 75% the next year.


The fund reports that it is up overall 25% for 5 years and produces a wonderful chart. However, the fund has lost $37.5M dollars net since its inception.

What has happened with many funds is that the early record with few investors later brought many in that did poorly thereafter as it became difficult to produce results with so much money to place.

I don’t care how much the fund price has gone up, I want to know how the investors have done. We are never told this number.

Deskjockey
I invested $2k per year into my retirement funds since 1978. I put $2500 a year (the amount I got from my employer that would have been his contribution to medical coverage) into mutual funds to be used for medical expenses. In 1984 I married my wife and she joined me in this program. She put in $2500 a year as well as fully funding her retirement. Our medical fund is not pre-tax and we stopped funding it 3 years ago. Its approximate value at this time is $660,000. is that what you were looking for?

No it was data for the 90 years
I'm pleased that you have been able to be part of one of the greatest stock market periods in history. I wish everybody would do what you did and be responsible to got off the DC utter. However, I would like the giver-ment to remove the tax deferred status of those plans. I shouldn't be paying for your savings.

Actually, I was looking for any data you had for the 12% for 90 years, a macro not micro/anecdotal data.

Deskjockey
Not pre-tax means I paid taxes on the money then put it in the fund so I did pay taxes on it as well as on the interest. Our retirement plans are tax deferred but that only means we have to pay taxes on it when we take money out.
I will try but I may or may not be able to find the actual publication where I read those figures as it was in the mid-late 90's and I don't remember what one it was. You may have better luck since you know what you want to find out in more detail.

All Growth is Temporary
I have not found a 90 year cumulative record. I normally don't do other's research. However one who did summed it up as follows, "In mutual fund history, in 1968, Michael Jensen, an economics professor, wrote a paper in the Journal of Finance entitled "The performance of mutual funds." He argued that most funds, over time, could not perform well enough to recover their costs of doing business."

When the S&P 500 was created the index funds were created to solve the problem of general poor fund performance. Of course since '80 a blind sow could be a Wall Street Star. Few remember the prior days of when it was extremely difficult to make money in the market.

Funds did not make 12% average over the past 90 years because the first fund started 83 years ago and by the end of the depression most funds were down at least 75% and the ensuring years to '80 weren't that good.

I take the time to tell you this because I want to mention wisdom from a banker given to me 40 years ago when I'd get all hyped up on various stocks. "All growth is temporary". In short, use good judgement.

Deskjockey
First off mutual funds in their present form have been around since 1822 when the first one was introduced in Belgium. The first mutual fund in the US was actualy introduced in 1893 I think. A friend who is a broker said he hasn't seen anything that he can specifically point to saying what the overall historical performance of funds is but says that Small Caps have performed at or above 12% average returns for at least the past 80 years. He also said they tend to reflect the performance of funds as a whole but not well enough to use as a yardstick. He did say that bankers were notorious for downplaying the mutual fund and stock investment option because they have a vested interest in selling CD's and savings accounts. The other people to look out for according to him are life insurance salesmen because they want to sell you an investment that isn't an investment. The only exception to that rule were people who sold term insurance only and he said to be leary of them as well. You don't happen to belong to any of those groups do you?
I don't agree that all growth is temporary. Growth isn't consistent in the short term but in the long term is pretty steady and always trends upward.

snake0311 writes, 10, 2007 9:21 AM
DESKJOCKEYR RESPONDS

The first fund was 1923 in Boston started with three investors, the second one in 1924. I thought your 12% was for US funds only not Europe too.

Your friend’s anecdotal assumptions contradict fund performance researchers. Also small caps have not performed at 12%. If you just look at the ones that are still solvent it isn’t 12% let alone accounting for the millions that tanked. Similarly the DJ is not up from 40.94 in 1896 to 13,064 today. Of the first 12 stocks only GE is still in the DJ. When the others go under, dissolve or perform badly they are replaced. Also small caps have a high incidence of going under. If you had put 1 dollar in every small cap stock 80 years ago, you’d have little of your money left.

Major banks now own securities divisions, so I don’t know why they talk down that division. Why listen to your local banker for stock advice when you are supposed to get that from your CPA or dentist. Insurance people often sell their own firm’s mutual funds so I don’t know why they are against them. Can’t trust those insurance guys, selling junk they are against.

I was Accounts VP of PaineWebber (now UBS Finanacial) and we sold stocks, insurance, options, commodities, tax shelters, CDs, tax free bonds, etc. I maintain a handful of brokerage accounts today and bought my first stock over 50 years ago.

Did Penn Central’s growth trend up? What about Pan Am and Eastern Airlines. What about American Home Mortgage filing bankruptcy after being $27 a share just a couple weeks earlier (a month ago), MCI, Enron, and the literally millions of listed companies that have gone bankrupt. If you look at all the money that has been invested and the comparatively few companies that remain today, the market has not been kind. To remove stocks out of the DJ continually to massage the appearance that all stocks have gone up for the past 100 years is deception if used for that representation.
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